Fetomaternal outcomes of cesarean delivery performed in the first and second stage of labor - an analytical prospective observational study
Pillai Arthi Karunanithi,Chithra AK,Punithavathi J
Objectives: Cesarean section at full cervical dilatation has many implications for maternal and neonatal morbidity as well as in subsequent pregnancy outcomes. The study compared neonatal and maternal outcomes of the cesarean sections performed in the first stage versus the second stage of labor. Methods: This is a two-year analytical prospective observational study conducted at a tertiary care research institute. A total of 339 participants were included. Patients who underwent cesarean delivery in the first stage of labor were 303(controls). The second stage was 36(cases) and was compared in maternal demographics, labor characteristics, maternal and neonatal outcomes. Differences were considered statistically significant if p value was <0.05. Results: The majority of (n=15, 41.67%) cases and controls (n=162, 53.46%) were in the age group of 21-25 years. There was no significant difference in age between cases and controls. Cesarean delivery performed in the second stage was associated with increased maternal morbidity such as difficulty in head delivery, haemorrhage, uterine angle extension, and the results were statistically significant between cases and controls (P<0.05). Apgar score <7 at five minutes was observed in very less proportion of cases (n=1, 2.78%) and controls (n=2, 0.66%). No statistically significant difference was seen in Apgar score at five minutes and fetal injury between the two study groups. Conclusion: Cesarean section in the second stage of labor is a technically demanding procedure with an increased risk of maternal and neonatal morbidity compared to the cesarean section in the first stage of labor.